Pharmacological rationale for antihypertensive drug choice on COVID‐19–affected patients: ACEI/ARB might not increase their susceptibility

• Published in: Journal of Cellular and Molecular Medicine 2020-11, Vol.24 (21), p.12879-12881
• Main Authors: Zhao, Hong‐Jin, Yang, Xiao‐Mei, Wang, Ai‐Hong, Li, Yan
• Format: Article
• Language: English
• Subjects: ACE2; Aging; Angiotensin Receptor Antagonists - pharmacology; Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-converting enzyme 2; Angiotensin-Converting Enzyme 2 - genetics; Angiotensin-Converting Enzyme 2 - metabolism; Angiotensin-Converting Enzyme Inhibitors - pharmacology; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Animals; Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Antihypertensives; Comorbidity; Conflicts of interest; Coronaviruses; COVID-19; COVID-19 - drug therapy; COVID-19 - metabolism; Editing; Enzymes; Female; Humans; Hypertension; Hypertension - drug therapy; Hypertension - epidemiology; Infections; Inflammation; Letter to the Editor; Pneumonia; Premenopause; Severe acute respiratory syndrome coronavirus 2; Supervision; Writing
• ISSN: 1582-1838; 1582-4934
• DOI: 10.1111/jcmm.15850

[...]a note of caution is needed when interpreting the roles of ACE2 expression levels in SARS‐CoV‐2 infection as the cleaved ACE2 could not function as the receptor for coronavirus to invade the target cells. [...]the ratio of severe COVID‐19 cases rises along with ageing, with the highest ratio in ≥65‐year‐old patients (44/153 = 28.7%)11 which is reversely correlated to the lung ACE2 levels. [...]SARS‐CoV in 2003, sharing the same receptor ACE2, shows different age group preferences in contrast to SARS‐CoV‐2. [...]a RAS imbalance has been widely accepted to account for the exacerbation of inflammatory pneumonia and hypertension. [...]to achieve RAS system rebalance, most Chinese experts now recommend the administration of ACEI/ARB for the hypertensive treatment, especially in COVID‐19 patients.